Arbitration Appeals Supervisor - Remote

US Anesthesia Partners, Inc.

21h•Remote

About The Position

The Supervisor – Arbitration Appeals is responsible for the oversight, management, and strategic direction of post-closure arbitration review and reopening activities for Federal and State out-of-network disputes utilizing the independent dispute resolution processes. This role supervises the staff responsible for the review, investigation, and reopening of closed out-of-network disputes utilizing the Federal independent dispute resolution processes, known as “arbitration,” including assessing whether errors occurred in dispute closure and pursuing corrective action when appropriate. At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska. The base pay estimate for this role is $55,300 - $88,400 annually. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for an annual bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.

Requirements

High school diploma or equivalent.
5 years of related healthcare, arbitration, appeals, or dispute resolution experience
Excellent written and verbal communication skills.
Intermediate skills in Microsoft Word and Excel is required
Ability to be detail oriented and organized with ability to prioritize.
Must display teamwork attitude and good inter-personal skills.
Organized with strong attention to detail.
Ability to prioritize and organize work and projects to ensure focus on high impact/value-added activities and meet deadlines.
Ability to identify trends to gain efficiencies in day-to-day work; sharing knowledge with colleagues.
Ability to communicate effectively in writing.
Ability to work independently with limited supervision.
Willing to learn new processes.
Ability to effectively work well under pressure in a fast-paced environment.

Nice To Haves

Previous supervisor or lead experienced preferred.
Prior healthcare experience and/or appeal work is a plus.
Advanced knowledge of Federal and State arbitration processes, CMS guidance, and post-closure dispute handling preferred.
Demonstrated leadership skills with the ability to coach, mentor, and develop team members.
Advanced level skill in computer applications including MS Word, MS Excel.
Advanced knowledge of payor processes and healthcare billing. Anesthesia experience preferred.
Knowledge of basic medical terminology and concepts preferred.
Knowledge of CPT, ICD-9, and ASA coding preferred.
Assist with special projects and perform other duties as assigned.

Responsibilities

Supervises and provides day-to-day leadership for Arbitration Closure Appeals staff, including workload management, prioritization, coaching, and performance feedback.
Oversees the investigation and evaluation of closed Federal and State arbitration disputes to ensure determinations regarding reopening or correction are accurate, consistent, and aligned with CMS technical assistance and regulatory requirements.
Analyzes closure and appeal data to determine prioritization.
Reviews and approves reopening and correction requests, including supporting documentation and escalation rationale, prior to submission when appropriate.
Serves as the escalation point for complex, high-risk, advising leadership on recommended actions.
Ensures post-closure timelines, deadlines, and follow-up actions are monitored and met in accordance with operational guidelines and regulatory standards.
Acts as the primary management contact for CMS, IDR entities, arbitrators, and Departments of Insurance on post-closure disputes, reopening requests, and related inquiries.
Establishes and maintains quality control standards for post-closure reviews, including audits of investigations, submissions, and outcomes to ensure accuracy and compliance.
Identifies, analyzes, and communicates trends related to improper closures, portal errors, recurring eligibility issues, or inconsistent application of arbitration rules.
Partners with arbitration leadership, compliance, legal, and operational teams to develop corrective actions, process improvements, and preventive controls to reduce future closure errors.
Develops and maintains reporting on post-closure activity, outcomes, trends, and risk indicators to support leadership decision-making and audit readiness.
Assists with training, documentation, and knowledge sharing to ensure staff remain current on CMS guidance, regulatory updates, and internal standards.
Supports special projects, regulatory initiatives, and continuous improvement efforts related to arbitration operations and post-closure review.